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Joggers Foot

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Other Names

  • Medial Plantar Neuropraxia
  • Joggers Foot
  • Transient neuropraxia
  • Medial plantar nerve (MPN) impingement

Background

  • This page refers to neuropraxia of the Medial Plantar Nerve (MPN) seen in runners, commonly termed 'Joggers Foot'

History

Epidemiology

  • Rare and poorly described in the literature

Pathophysiology

A) Anatomy of the medial plantar nerve. B) Coronal T2 fat-saturated MRI labeled to illustrate the medial plantar nerve and adjacent structures.[1]
  • General
    • Uncommon disease, not well described in the literature
    • Symptoms occur due to compression of the medial plantar nerve
    • Classically described as burning pain along the medial heel and longitudinal arch

Etiology

  • Compression of the medial plantar nerve
    • Can occur in either the fibro-osseous tunnel (fascial sling) or the knot of henry
    • Typically occurs between the abductor halluces muscle and the knot of Henry [2]

Associated Conditions

Pathoanatomy


Risk Factors

  • Sports
    • Endurance Running[4]
  • Anatomic
  • Extrinsic
    • Compression due to poorly fitted or new footwear
    • Compression from insertional orthoses

Differential Diagnosis


Clinical Features

  • History
    • Pain and numbness at the medial heel and arch radiating towards the first and second toe[3]
    • Pain may be described as shock-like or burning [5]
    • Symptoms may coincide with implementation of new footwear or an orthosis.
  • Physical: Physical Exam Foot
    • Palpate for pain along the medial arch [6]
    • Pain with Abductor Hallucis palpation, specifically at navicular tuberosity
    • Reproduced pain and tingling with nerve percussion and forced passive heel eversion
    • Standing on the balls of the feet may worsen symptoms
    • Because symptoms are often exercise induced, may be normal unless performed immediately after running
  • Special Tests

Evaluation

Radiographs

MRI

  • Unclear role in diagnosis
    • Diagnosis on MRI has been briefly described in literature
    • Findings specific to Jogger's Foot have not been reported[7]
  • May help exclude
    • Space-occupying lesions in the tarsal tunnel
    • Radiographically occult midfoot arthritis
    • Tendon pathology at the MKH

Ultrasound

  • May be useful
  • Exact role in diagnosis is unclear

Diagnostic Nerve Block

  • May be useful to confirm diagnosis

Classification

  • Not applicable

Management

Nonoperative

  • Indications
    • Most cases
  • NSAIDS
  • Orthotics
    • Rigid foot orthotics should be modified, replaced or removed to avoid compression
  • Foot wear modification
  • Activity modification
    • Running mechanics may need modification
  • Physical Therapy
    • Hyperpronation may be addressed by medial arch strengthening, kinetic chain rehabilitation

Operative

  • Indications
    • Refractory to conservative treatment
  • Technique
    • Surgical release

Rehab and Return to Play

Rehabilitation

  • Needs to be updated

Return to Play

  • Needs to be updated

Complications and Prognosis

Prognosis

  • Unknown

Complications

  • Unknown

See Also


References

  1. Collins, Mark S., Christin A. Tiegs-Heiden, and Matthew A. Frick. "MRI appearance of jogger’s foot." Skeletal Radiology 49.12 (2020): 1957-1963.
  2. Luis Beltran, J. B. (2010). Entrapment Neuropathies III: Lower Limb. Seminars in Musculoskeletal Radiology, 501-511.
  3. 3.0 3.1 David Del Toro, A. N. (2018). Guiding Treatment for Foot Pain. Physical Medicine and Rehabilitation Clinics of North America, 783-792
  4. Rask M. Medial plantar neuropraxia (Jogger’s foot). Clin Orthop Relat Res. 1978;181:167–70.
  5. Ali Alshami, T. S. (2008). A review of plantar heel pain of neural origin: Differential diagnosis and management. Manual Therapy, 103-111
  6. Norman Espinosa, G. K. (2020). Peripheral Nerve Entrapment Around the Foot and Ankle. In M. M. Thompson, DeLee Drez & Miller's Orthopaedic Sports Medicine (pp. 1402-1420). Philadelphia: Elsevier.
  7. Donovan A, Rosenberg ZS, Cavalcanti CF. MR imaging of entrapment neuropathies of the lower extremity part 2. The knee, leg, ankle and foot. Radiographics. 2010;30:1001–19.
Created by:
Greg Rubin on 19 June 2019 13:15:16
Authors:
Last edited:
4 October 2022 12:41:53
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